Early verus late glucose monitoring in recurrent gestational diabetes
Research type
Research Study
Full title
An observational nested multicenter cohort study of early versus late monitoring among pregnant women with a history of gestational diabetes
IRAS ID
304605
Contact name
Natasha Singh
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
During pregnancy the hormones released from the placenta can make cells in the body respond less well to insulin and the body has to increase production of insulin. But some women cannot produce enough insulin or their body is more resistant to insulin causing blood glucose levels to remain high and in pregnancy this is called Gestational Diabetes (GDM). The incidence of GDM in increasing and the risk of recurrent gestational diabetes is about 35-75%. GDM is associate with risks in the pregnancy such as big babies, difficult births, premature births, excessive amniotic fluid and stillbirth. Equally important woman and their offspring have >40% risk of type 2 diabetes (T2DM), obesity and cardiovascular disorders causing a vicious transgenerational cycle. Recent NICE guidance suggests that we should offer women with a history of GDM either early monitoring of their blood glucose of testing with a full oral glucose tolerance test at 16-28 weeks. Practices across the UK varies and we do not know which is more effective at reducing the short and long term risks of GDM in the pregnancy. Our aim is to study two groups of women: early blood glucose monitoring (Chelsea and Westminster groups) and later monitoring (Birmingham Women’s and St Georges Hospital) and determine if there is a difference in short and longer-term outcomes. We plan to use blood and urine samples from the women to study if the mechanisms that cause GDM can be modified. We also plan to use umbilical cord blood to study which treatment option is less effective at switching on the genes (epigenetics) for T2DM, obesity and cardiovascular disease in the offsprings. We will use samples from the placenta to compare the insulin and glucose pathways involved the development of GDM. We plan to disseminate our findings via conferences linked to Diabetes UK and GDM support groups. The women and their clinicians will benefit from knowing which care is better for in pregnancy and this will be important in standardising and influencing care which reduces the risk of GDM and capable of breaking the transgenerational cycle of recurrent GDM and T2DM.
REC name
South East Scotland REC 01
REC reference
22/SS/0044
Date of REC Opinion
14 Dec 2022
REC opinion
Further Information Favourable Opinion